Shortridge, Stephen Matthew
Shortridge, Stephen Matthew is an individual health care provider with primary practice located at 3066 E Meridian Park Loop , Wasilla AK 99654-7372. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Shortridge, Stephen Matthew can be contacted via phone (907) 373-9460.Contact Information
Primary practice address
3066 E Meridian Park Loop
Wasilla AK 99654-7372
Phone: (907) 373-9460
Fax: (907) 373-9461
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 394 | Alaska |
Profile Details
| NPI number | 1700994118 |
|---|---|
| LBN Legal business name | Shortridge, Stephen Matthew |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2006 |
| Last updated | Sep 29th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700994118 | NPPES |
| Alaska | MEDICAID | 1020264 |
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